Correlation between plasma homocysteine level and atherosclerotic quasi-moyamoya disease

Abstract

Objective To investigate the correlation between plasma homocysteine (Hcy) level and atherosclerotic quasi-moyamoya disease. Methods Ninety-five ischemic stroke patients with atherosclerotic quasi-moyamoya disease (quasi-moyamoya disease group), 95 patients with large atherosclerotic cerebral infarction (stroke group), and 94 healthy volunteers (control group) were selected. The plasma Hcy level was detected, the demographic data, vascular risk factors, and laboratory findings were collected. The correlation between plasma Hcy level and atherosclerotic quasi-moyamoya disease was analyzed. Results There were significant differences in the proportions of patients with hypertension, hyperlipidemia, previous stroke or transient ischemic attack (TIA), hyperhomocysteinemia (HHcy), as well as systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), Hcy, vitamin B12, and folate levels between the quasi-moyamoya disease group and the control group (all P<0.017). There were significant differences in the proportion of patients with previous stroke or TIA, as well as systolic blood pressure, and folate level between the quasi-moyamoya group and the stroke group (all P<0.017). Compared with the control group, multivariate logistic regression analysis showed that HHcy (odds ratio [OR] 1.806, 95% confidence interval [CI] 1.348-2.420; P<0.001), previous stroke or TIA (OR 3.519, 95% CI 1.709-7.028; P=0.013), systolic blood pressure (OR 1.099, 95% CI 1.035-1.168; P=0.002), and LDL-C (OR 38.473, 95% CI 6.384-231.842; P<0.001) were the independent risk factors for atherosclerotic quasi-moyamoya disease, while HDL-C (OR 0.025, 95% CI 0.001-0.768; P=0.035) and folate (OR 0.779, 95% CI 0.608-0.996; P=0.047) were its independent protective factors. Compared with the stroke group, multivariate logistic regression analysis showed that previous stroke or TIA (OR 3.280, 95% CI 1.664-6.466; P=0.001) and systolic blood pressure (OR 1.019, 95% CI 1.002-1.035; P=0.029) were the independent risk factors for quasi-moyamoya disease, while folate (OR 0.845, 95% CI 0.750-0.952; P=0.006) was its independent protective factor. Conclusions The elevated plasma Hcy level is an independent risk factor for atherosclerotic quasi-moyamoya disease. It plays an important role in its pathogenesis. Key words: Moyamoya Disease; Stroke; Brain Ischemia; Intracranial Arteriosclerosis; Homocysteine; Cerebral Angiography